Upskilling Professional Competency of Health Workers in the

Era of the Covid-19 Pandemic at Bintang Amin Hospital,

Lampung
Febby Sonia1, Suryanto2
1,2
Program Magister Pengembangan Sumber Daya Manusia, Sekolah Pascasarjana, Universitas Airlangga,
Indonesia
febby.sonia-2020@pasca.unair.ac.id, suryanto@psikolog.unair.ac.id

Abstract Keywords
Upskilling professional
This study aims to analyze the need for competency improvement
carried out by hospitals. Up skilling professional competency competency; health services;
organized by the hospital aims to increase the knowledge and health workers
competence of health workers to provide optimal health services.
This study used a descriptive qualitative approach and was
obtained by in-depth interviews. The collected data was then
analyzed using thematic analysis according to the category of the
results of the interview topics. The results indicate Upskilling
professional competency needs to be carried out with theoretical
and practical modules so that the process of improving
comprehension and putting learning into practice can be done
successfully and efficiently. Upskilling professional competency
includes learning related to hard skills, soft skills, patience,
emotional awareness, and knowledge to deal with the Covid-19
pandemic. The results are expected that hospitals can continue to
take part in Upskilling professional competency by providing
regular training on topics such as patient service standards,
especially for Covid-19 patients, good and effective
communication, and sufficient knowledge to provide health
services during the Covid-19 pandemic.

I. Introduction

The Covid-19 pandemic caused everyone to behave beyond normal limits as usual.
One of the behaviors that can change is deciding the decision to choose a college. The
problem that occurs in private universities during covid 19 is the decrease in the number of
prospective students who come to campus to get information or register directly to choose
the department they want. (Sihombing, E and Nasib, 2020)
The world health agency (WHO) has also announced that the corona virus, also
called COVID-19, is a global threat worldwide. The outbreak of this virus has an impact
especially on the economy of a nation and globally. These unforeseen circumstances
automatically revised a scenario that was arranged in predicting an increase in the global
economy. (Ningrum, P. et al. 2020)
The Covid-19 outbreak caused by the Corona Virus appeared in December 2019 in
Wuhan, China, and spread rapidly to all countries in the world (Madero Gómez et al.,
2020). As of August 2020, there were more than 23.3 million confirmed cases of Covid-19
and more than 800,000 deaths reported globally (Abbas, 2021). A large number of cases
have a major impact on the quality of the health care system provided by the hospital
(Babroudi et al., 2021).

______________________________________________________________
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DOI: https://doi.org/10.33258/birci.v5i1.3944
 Budapest International Research and Critics Institute-Journal (BIRCI-Journal)
Volume 5, No 1, February 2022, Page: 3020-3029
e-ISSN: 2615-3076 (Online), p-ISSN: 2615-1715 (Print)
www.bircu-journal.com/index.php/birci
email: birci.journal@gmail.com
The high pressure on the quality of the health care system received by hospitals
requires adaptation to ongoing conditions (Shah et al., 2021). One of these conditions
affects the quality decline experienced by health workers in providing health services
(Prokopenko et al., 2020). Therefore, hospitals need to pay attention to the competence of
health workers in providing health services (Cui et al., 2021).
This study analyzes the upskilling of the professional competency of health workers
and contributes to the literature in several ways. For instance, previous research has
suggested that competency development for health workers should be based on
competency standards (Silviana & Darmawan, 2017), while this research will result in
competency development that can be used throughout the Covid-19 Pandemic and beyond.
Second, previous research conducted competency development, which only focused on the
European Union region (Panteli & Maier, 2021). Therefore, the current research takes
locations in Indonesia so that competency development can be following the needs of
hospitals and health workers in Indonesia.
Even though every hospital is experiencing a slump in the conditions of the Covid-19
Pandemic, they are still trying to survive in providing optimal health care for suspected
patients and active cases (Zulueta, 2021). Upskilling the professional competency of health
workers, according to Czabanowska & Kuhlmann (2021), can help to generate excellent
health care.
The importance of upskilling professional competency will assist their task in
handling and breaking the chain of transmission of the Corona Virus (Nemati et al., 2020).
The increase in competence carried out by hospitals is a response to the decline in the
quality of health services during the Covid-19 pandemic. It is necessary to ensure public
safety and maintain the professional ability of health workers in dealing with crises that
occur (Gharaibeh et al., 2020).
Analysis of the professional needs and abilities of health workers in this study uses
the theory of professional competency proposed by Charles E. Johnson. Professional
competency, according to Charles, is an individual's knowledge of a variety of topics that
are closely related to the execution and fulfillment of particular tasks and duties in the
work they do.
Based on CNN Indonesia (2021), throughout 2021, Lampung Province was recorded
as the area in Indonesia with the highest death rate due to Covid-19. Based on data from
the Ministry of Health, from January 1, 2021, to August 8, 2021, the death rate in
Lampung reached 7.1 percent (TEMPO, 2021). The number of Covid-19 patients in
Lampung continues to grow, so the Lampung Provincial Government takes steps to
increase the number of health workers who serve as the front line (Merdeka, 2020).
Therefore, researchers feel the need to conduct a study on upskilling professional
competency of health workers in the era of the covid-19 pandemic at Bintang Amin
Hospital, Lampung.
This research is expected to have important implications for the practical and
academic world. In the practical world, this research can be useful in providing additional
insight to previous research regarding upskilling professional competency to increase
knowledge and competence in providing optimal health services for Covid-19 patients. The
results can be used as reference material or for theory development related to upskilling
professional competency to increase the level of knowledge and competence of health
workers during the Covid-19 pandemic at Bintang Amin Hospital in Lampung.

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 II. Research Method

Draft. This research is descriptive research with a qualitative approach. Finding truth
and evaluating descriptive data processes in writing or verbally from research subjects who
are observed based on linked phenomena while following the steps of scientific research
activities is what qualitative research is all about. Descriptive research with a qualitative
approach is used to provide an overview of the professional competency upskilling of
health workers at Bintang Amin Hospital, Lampung. This research is supported by
qualitative data to provide a deeper explanation of upskilling professional competencies
that develop and improve knowledge and competencies to provide optimal health services.
Participants. The participants in this study were nurses and doctors who worked at
Bintang Amin Hospital in Lampung. This participant has been at the forefront for 1.5 – 6
years. The determination of 1.5-6 years is assumed that health workers working at
Pertamina Bintang Amin Hospital in Lampung have understood the role and function of
upskilling professional competency of health workers in the era of the covid-19 pandemic.
The researchers used semi-structured and in-depth interview techniques as a data collection
technique. It is designed to allow researchers and participants to engage in in-depth
discussions to learn about the upskilling of health workers' professional competency in the
period of the covid-19 pandemic as the front line.
Data analysis. In this study, researchers used thematic analysis, which is believed to
be the foundation for data analysis activities in qualitative research. Thematic analysis is a
way for analyzing data to uncover a theme within all of the information gathered by the
researcher. Thematic analysis has stages that must be passed such as data reduction, data
organization, and data interpretation. Therefore, the interview results will be analyzed
based on important and interesting topics and then explained in a research report.

III. Results and Discussion

3.1 Description of Professional Competency of Health Workers

Individuals and communities who get services gain from the use of communication
skills, habits, knowledge, technical skills, clinical reasoning, emotional values, and
reflection in everyday practice. It builds on clinical skills, scientific knowledge, and moral
development. In line with the perspective held by the interviewees during the interview, it
was found that the Professional Competency of health workers is needed to provide
optimal health services. The researchers discovered several indicators of Professional
Competency of health workers during the interview, including the ability to use knowledge
to solve a problem that arises and skills in biomedical and psychosocial data processing to
gain a detailed understanding of the patient's clinical problems. In addition, effective
communication skills are used to relate to patients and colleagues. Moreover, they also
need the ability to deal with problems with patience and emotional awareness. Based on
interviews with participants A and B as health workers at Pertamina Bintang Amin
Hospital in Lampung, Nit was found that a health worker who has Professional
Competency is as follows:
Participants A and B said,
"A health worker who has Professional Competency can be seen from the
collaboration between intellectuals and their abilities in providing effective and
sustainable performance to solve a problem such as the current Covid-19
pandemic." (M)

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 “A good health worker must have hard skills and soft skills that are supported by
broad insight to deal with the current crisis, namely the Covid-19 Pandemic. These
capabilities are also implemented to treat suspected patients and active cases and
break the chain of Corona Virus spread." (FR)
According to the statement above, the ability to provide maximum health services to
patients requires both hard and soft skills and comprehensive insight. Health workers
believed that hard skills and soft skills accompanied by wide insight reflected not only a
health professional but also the hospital where they worked at the time the interview was
performed. Bintang Amin Hospital Lampung has the goals of "realizing quality,
professional health services by prioritizing patient safety" and "becoming a referral
hospital for private hospitals in Lampung Province". Based on these objectives, it can be
seen that hard skills and soft skills supported by broad insight are things that have become
an important part of the process of providing health services to suspected patients and
active cases of Covid-19.
In addition to both hard skills and soft skills supported by broad insight, a health
worker must have effective communication skills and a patient attitude as well as
emotional awareness so that the handling of suspected patients and active cases of Covid-
19 can be carried out optimally. This was stated by participants C and A. The two
participants stated that:

"Each individual has a different level of patience and emotional awareness, ranging
from low, medium, to high. As health workers, we are required to have a patient
attitude and high emotional awareness towards other individuals, especially
patients. This is not only stated in the vision and mission of the hospital but is also
a form of our concern for the patients we are dealing with." (RP)
"One of the visions and missions that our hospital has is excellent and quality
service as well as providing professional quality in health services. In this case,
patience and emotional awareness will certainly be needed in dealing with
patients. However, this needs to be supported by good communication skills so that
the delivery of information in health services can be received effectively by
patients.” [M]

From the statements of the two participants, the attitudes and skills of a health
worker are also highly demanded to produce a better impact on not only patients but also
hospitals. The quality of a health worker's Professional Competency will be improved if
they master patience and emotional awareness, as well as communication abilities.
The interviews result that have been conducted found that this is in line with
Wahyuni & Raharja (2021) that the competencies possessed by health workers will have a
major influence on the quality of health services provided to suspected patients and active
cases of Covid-19. According to Camelo & Angerami (2013), Professional Competency is
the skills and knowledge possessed and can be implemented to complete work-related
tasks in certain conditions. This has an important relationship in providing optimal health
services to patients during the Covid-19 pandemic.
Hard skills, soft skills, intellectual, patient attitude, and emotional awareness, as well
as communication abilities, are all indicators of professional competence. Some of these
indicators help health workers in providing maximum health services to patients, especially
suspected patients and active cases of Covid-19 (Leethongdissakul et al., 2020). This
statement is supported by information from Participant D as follows:

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 " Professional competence in health workers generally includes intellectual, patient
attitude in dealing with the wishes and needs of patients or the possibility of conflicts
that occur between health workers and patients, hard skills, soft skills, emotional
awareness, and communication skills so that the delivery of information conveyed by
health workers can be given effectively and efficiently to patients, especially
suspected patients and active cases of Covid-19 that emerged during this
Pandemic.” [ICE]
Based on the statement, Professional Competency is a core part of providing health
services; this is also considered as a form of professional responsibility as a health worker
so that public health welfare can be well maintained on an ongoing basis. Thus, health
workers are a very important profession in providing quality and comprehensive health
services (Witt et al., 2014). Therefore, the Professional Competency of health workers is
very much needed by health workers to handle suspected patients and active cases and
break the chain of the spread of Covid-19.

3.2 Upskilling Professional Competencies of Health Workers in the Pandemic Era

Covid-19
The current Covid-19 pandemic is a complicated problem that exists in all countries
in the world, including Indonesia. The increasing number of infections and deaths from the
outbreak has made the work of health workers as the frontline workers more and more
increasing. Other issues developed, such as a decline in the quality of health treatment for
Covid-19 patients due to a lack of Professional Competency in the form of knowledge and
competencies possessed by health personnel. Because health workers are considered as the
front line, Upskilling professional competency is needed to provide optimal health services
to suspected patients and active cases of Covid-19.
Upskilling professional competency is important to do through continuous learning
and development in hospitals to improve skills, improve practice, and close gaps in
knowledge of health workers. Upskilling professional competency is the process of
learning new skills or perfecting existing skillsets for health workers to provide optimal
health services during the Covid-19 Pandemic (Gasteiger et al., 2021). This skill
improvement is needed to ensure that the health services provided by health workers are
carried out safely and in line with the best standards.
Based on the results of the interview, Upskilling professional competency was
carried out with several learning and development materials as shown in the image below.

Figure 1. Upskilling Module for ICU Doctors

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 Figure 2. Upskilling Module for ICU Nurse

Upskilling professional competency uses the theoretical stage and the practical stage
to maximize the learning and development provided to health workers. This activity was
attended by all health workers who served in the ICU (Intensive Care Unit) and amounted
to 25 people with a period of 1-3 times a year. The Upskilling professional competency has
the aim of maintaining and improving the quality of health services in handling suspected
patients and active cases of Covid-19 provided by health workers. This is as expressed by
participant B, namely:

“The hospital hopes that all health workers, especially those who work in the ICU,
can provide health care according to the patient's needs. Due to the current Covid-19
pandemic, there are still many health workers who lack the knowledge and
competence in handling suspected and active Covid-19 patients. Therefore, the
hospital organizes Upskilling professional competency which aims to increase the
insight and competence needed by health workers in dealing with active patients and
breaking the chain of Covid-19 spread." [ICE]

Upskilling professional competency is held to support the insight of superior health

workers and establish Professional Competency for health workers to create excellent
health services. This activity is carried out regularly through E-learning and Workshops on
issues connected to health services, such as expanding information about the Corona Virus
so that health workers' comprehension can broaden and their competence so that health
services can be carried out optimally. These competencies include hard skills, soft skills,
communication skills, patience, and emotional awareness. So, Upskilling is carried out as
an effort to improve the capability and quality of competence of health workers so that the
quality of health services owned by hospitals can also increase. This was also expressed by
participant C as follows:

“ This upskilling is carried out online with E-learning and workshops 1 to 3 times a
year due to adjusting to the conditions of the Covid-19 Pandemic. The Upskilling
professional competency was held to increase the capability and quality of health
services that we have as health workers in dealing with every patient in the hospital,
especially Covid-19 patients, which began to increase in this crisis. In this activity,
we also explain the vision and mission as a reminder of all human resources in the

3025
 hospital. Based on the evaluation we carried out, Upskilling professional competency
is considered quite effective and efficient because it can not only be done anywhere
but also results in patient satisfaction, especially Covid-19 patients who are treated
by health workers in our hospital” [RP]

Health workers will be reminded of good health service standards in providing

patient care in hospitals and accordance with current crisis conditions. This action is
intended to serve as a reminder to health workers who provide health services in hospitals
to remember the hospital's vision, mission, and regulations, as this will reflect the level of
competence possessed by health workers when dealing with Covid-19 patients, allowing
the increase in patient satisfaction to continue.

“Health workers need to remember health service standards because this can have an
impact on patient satisfaction which will certainly affect the quality of health
workers' performance. This will also be supported by Professional Competency so
that the Upskilling of Professional Competency in health workers is held so that the
goals desired by hospitals and health workers can be achieved to the
maximum.” [FR]

In addition, the role of the vision and mission as well as the regulations owned by the
hospital strongly support the Upskilling professional competency aimed at health workers.
In this time of crisis, the hospital's vision and goal, and its regulations, are used as a
guideline for delivering the best possible health care to suspected Covid-19 patients and
active cases. During the Covid-19 pandemic, health workers on the front lines will be
expected to make a maximum contribution to patient care, which will include using
knowledge to solve a problem that arises, biomedical and psychosocial data processing
skills to gain a detailed understanding of the patient's clinical problems, effective
communication skills to relate to patients, and patience and emotional awareness to deal
with any problems that arise. This statement is supported by participant B and participant
A, namely as follows

“Upskilling professional competency must be possessed by us as health workers

because we are the front line in dealing with Covid-19 patients, many of us are still
lacking in insight and competence to provide health services in this crisis. However,
we remember that hospitals have a vision, mission, and regulations that must be
remembered and implemented so that we continue to try to follow programs held by
hospitals such as Upskilling professional competency so that we can provide optimal
health services and produce satisfaction because of the healing experienced by the
hospital patients, especially patients infected with the Corona Virus.” [FR]
"We as health workers must always follow the conditions that occur, especially when
the Covid-19 Pandemic has occurred which has infected public health. This hospital
also has a vision, mission, and goals that we need to remember and achieve.
Therefore, we must always evaluate our competence, whether it is following the
needs of health services. If we feel that health services are not sufficient, then we are
obliged to take part in Upskilling professional competency so that we can provide
optimal health services to Covid-19 patients.” [M]

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 As a result, the role of health personnel as the front line in delivering the best
possible care to suspected Covid-19 patients and active cases is critical. Upskilling
professional competency is thus required to maximize health workers' awareness and
ability to provide optimal health care. It is also regarded as the responsibility of a health
worker who is responsible for the community's health. This activity is being carried out in
the hopes of improving the quality of health services given by health workers, allowing
hospitals to have a positive impact on healing and public health.

IV. Conclusion

According to the findings of this study, Upskilling professional competency should

be maintained because the quality of health services given by health workers is declining.
This is a topic that needs to be carefully studied in the context of the Covid-19 Pandemic
because the recovery of Covid-19 patients is dependent on the competency of health staff.
Health experts who utilize their expertise to guide them through the treatment process and
help them heal treat patients.
Upskilling professional competency is utilized to develop health workers'
knowledge and establish Professional Competency for health workers to provide optimal
health services for Covid-19 patients' healing. Upskilling professional competency is
carried out online every 1 to 3 times a year because it adapts to the current crisis
conditions. This activity also applies theoretical and practical learning so that the
knowledge provided can be understood and applied effectively and efficiently by health
workers. Thus, Upskilling professional competency is carried out not only to support the
need for competencies possessed by health workers and the need for quality hospital health
services but also to improve community recovery and break the chain of the spread of
Covid-19.
Suggestions
During the research process, the researcher recognizes that this research is still
flawed and has some limits. Researchers face several challenges, including the inability to
see directly the actions and conditions of learning implementation received by health
workers after participating in Upskilling Professional Competency. Second, the research
object is limited to health institutions, but many other industries require research into
human resource capabilities.
Based on the restrictions that researchers have encountered during research activities,
additional researchers can be advised to perform direct observations at the research site to
obtain accurate observation data that can be utilized to support research findings. Second,
research can leverage research objects from other businesses to identify competency
improvements across the board during the Covid-19 pandemic, rather than just in the
health sector.

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